BSN HESI 315 Pharmacology Practice Exam V2 (New 2024/
2025 Update) Questions and Verified Answers Plus
Rationales|100% Correct| Grade A-Nightingale
1.
A patient receiving digoxin 0.25 mg daily has a serum digoxin of 2.5 ng/mL.
What should the nurse do first?
A. Administer the next dose as scheduled
B. Hold the dose and notify the provider
C. Encourage fluids
D. Give potassium supplement
Answer: B
Rationale: Therapeutic range 0.5–2.0 ng/mL; > 2 ng/mL = toxicity risk. Hold and notify
provider.
2.
During warfarin therapy, which lab is monitored for efficacy?
A. aPTT
B. INR
C. Platelets
D. Hgb/Hct
Answer: B
Rationale: Warfarin effectiveness measured by INR (therapeutic 2–3).
3.
A client taking lisinopril reports dry, persistent cough.
Which nursing action is appropriate?
A. Reassure as transient
B. Discontinue and notify provider
C. Increase fluid intake
D. Add decongestant
Answer: B
Rationale: ACE inhibitors may cause bradykinin-mediated cough → switch to ARB.
4.
A patient on furosemide reports muscle cramps.
Which lab finding is expected?
A. K⁺ 5.8 mEq/L
B. K⁺ 2.9 mEq/L
C. Na⁺ 140 mEq/L
,D. Ca²⁺ 10 mg/dL
Answer: B
Rationale: Loop diuretics → hypokalemia → muscle cramps.
5.
Which instruction is essential for a patient starting levothyroxine?
A. Take with food each morning
B. Take on empty stomach before breakfast
C. Skip dose if tachycardic
D. Use with antacids for absorption
Answer: B
Rationale: Absorption best on empty stomach; separate from antacids/Ca/iron.
6.
Why is metoprolol contraindicated in some asthma patients?
A. Stimulates β₂ receptors
B. Blocks β₂ in lungs causing bronchoconstriction
C. Causes hypoglycemia
D. Has anticholinergic effects
Answer: B
Rationale: Non-selective β-blockade may precipitate bronchospasm.
7.
Teaching for nitroglycerin sublingual tablets should include:
A. Swallow whole
B. Expect tingling under tongue
C. Take with meals
D. Avoid rest after taking
Answer: B
Rationale: Tingling = drug potency; sit to avoid hypotension.
8.
Which insulin has no peak and provides 24-h coverage?
A. NPH
B. Glargine
C. Regular
D. Lispro
Answer: B
Rationale: Glargine (Lantus) = long-acting, steady basal coverage.
9.
, Early sign of digoxin toxicity:
A. Constipation
B. Yellow-green vision
C. Hypertension
D. Dry mouth
Answer: B
Rationale: Visual halos, nausea, bradycardia common early S/S.
10.
Which lab closely monitored with vancomycin IV?
A. AST/ALT
B. Trough levels and creatinine
C. Hgb/Hct
D. PT/INR
Answer: B
Rationale: Nephrotoxic—monitor renal function + trough 10–20 µg/mL.
11.
A patient with type 2 diabetes on metformin is scheduled for CT with contrast.
Best nursing action:
A. Administer metformin with contrast
B. Hold 24–48 h before and after procedure
C. Double the dose next day
D. Encourage protein shake after test
Answer: B
Rationale: Contrast + metformin may precipitate lactic acidosis.
12.
Antidote for benzodiazepine overdose:
A. Naloxone
B. Flumazenil
C. Atropine
D. Protamine sulfate
Answer: B
Rationale: Flumazenil competitively inhibits GABA receptor binding of benzodiazepines.
13.
What should nurse check before administering morphine?
A. Blood pressure only
B. Pain score and respiratory rate
C. Blood glucose
D. Coagulation panel
2025 Update) Questions and Verified Answers Plus
Rationales|100% Correct| Grade A-Nightingale
1.
A patient receiving digoxin 0.25 mg daily has a serum digoxin of 2.5 ng/mL.
What should the nurse do first?
A. Administer the next dose as scheduled
B. Hold the dose and notify the provider
C. Encourage fluids
D. Give potassium supplement
Answer: B
Rationale: Therapeutic range 0.5–2.0 ng/mL; > 2 ng/mL = toxicity risk. Hold and notify
provider.
2.
During warfarin therapy, which lab is monitored for efficacy?
A. aPTT
B. INR
C. Platelets
D. Hgb/Hct
Answer: B
Rationale: Warfarin effectiveness measured by INR (therapeutic 2–3).
3.
A client taking lisinopril reports dry, persistent cough.
Which nursing action is appropriate?
A. Reassure as transient
B. Discontinue and notify provider
C. Increase fluid intake
D. Add decongestant
Answer: B
Rationale: ACE inhibitors may cause bradykinin-mediated cough → switch to ARB.
4.
A patient on furosemide reports muscle cramps.
Which lab finding is expected?
A. K⁺ 5.8 mEq/L
B. K⁺ 2.9 mEq/L
C. Na⁺ 140 mEq/L
,D. Ca²⁺ 10 mg/dL
Answer: B
Rationale: Loop diuretics → hypokalemia → muscle cramps.
5.
Which instruction is essential for a patient starting levothyroxine?
A. Take with food each morning
B. Take on empty stomach before breakfast
C. Skip dose if tachycardic
D. Use with antacids for absorption
Answer: B
Rationale: Absorption best on empty stomach; separate from antacids/Ca/iron.
6.
Why is metoprolol contraindicated in some asthma patients?
A. Stimulates β₂ receptors
B. Blocks β₂ in lungs causing bronchoconstriction
C. Causes hypoglycemia
D. Has anticholinergic effects
Answer: B
Rationale: Non-selective β-blockade may precipitate bronchospasm.
7.
Teaching for nitroglycerin sublingual tablets should include:
A. Swallow whole
B. Expect tingling under tongue
C. Take with meals
D. Avoid rest after taking
Answer: B
Rationale: Tingling = drug potency; sit to avoid hypotension.
8.
Which insulin has no peak and provides 24-h coverage?
A. NPH
B. Glargine
C. Regular
D. Lispro
Answer: B
Rationale: Glargine (Lantus) = long-acting, steady basal coverage.
9.
, Early sign of digoxin toxicity:
A. Constipation
B. Yellow-green vision
C. Hypertension
D. Dry mouth
Answer: B
Rationale: Visual halos, nausea, bradycardia common early S/S.
10.
Which lab closely monitored with vancomycin IV?
A. AST/ALT
B. Trough levels and creatinine
C. Hgb/Hct
D. PT/INR
Answer: B
Rationale: Nephrotoxic—monitor renal function + trough 10–20 µg/mL.
11.
A patient with type 2 diabetes on metformin is scheduled for CT with contrast.
Best nursing action:
A. Administer metformin with contrast
B. Hold 24–48 h before and after procedure
C. Double the dose next day
D. Encourage protein shake after test
Answer: B
Rationale: Contrast + metformin may precipitate lactic acidosis.
12.
Antidote for benzodiazepine overdose:
A. Naloxone
B. Flumazenil
C. Atropine
D. Protamine sulfate
Answer: B
Rationale: Flumazenil competitively inhibits GABA receptor binding of benzodiazepines.
13.
What should nurse check before administering morphine?
A. Blood pressure only
B. Pain score and respiratory rate
C. Blood glucose
D. Coagulation panel
